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Revista médica de Chile

Print version ISSN 0034-9887

Abstract

QUEZADA, Felipe et al. Treatment of a severe Clostridium difficile infection with colonic lavages. Report of one case. Rev. méd. Chile [online]. 2015, vol.143, n.5, pp.668-672. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872015000500016.

A loop ileostomy with intraoperative anterograde colonic lavage has been described as an alternative to colectomy in the management of cases of Clostridium difficile infection refractory to medical treatment. We report a 69 years old diabetic women admitted with a septic shock. An abdominal CAT scan showed a pan-colitis that seemed to be infectious. A polymerase chain reaction was positive for Clostridium Difficile. Due to the failure to improve after full medical treatment, a derivative loop ileostomy and intra-operatory colonic lavage were performed, leaving a Foley catheter in the proximal colon. In the postoperative period, anterograde colonic instillations of Vancomycin flushes through the catheter were performed every 6 hours. Forty eight hours after surgery, the patient improved. A colonoscopy prior to discharge showed resolution of the pseudomembranous colitis.

Keywords : Clostr; Ileostomy; Vancomycin.

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